Transcript Jessica Jacobs September 15, 2010

Ambulatory
Electronic Health Records
Adoption Trends
2005-2010
Jessica Jacobs
September 15, 2010
What does Ambulatory Mean?
• Ambulatory providers are physicians who
perform the majority of their services outside
the hospital
– No more than 90% of their services are
performed at a hospital
• Currently there are 200,0000 physician
offices, 515,000 total practicing ambulatory
physicians*
https://questions.cms.hhs.gov/app/answers/detail/a_id/9844/~/[ehr-incentive-program]-are-physicians-who-practice-in-hospital-based
Note: Excludes radiologists, pathologists, anesthesiologists, ER and all other hospital-based physicians
In other words…
Them
Not Them
What is an EHR?
•
An Electronic Health Records (EHR) is “a longitudinal electronic record of patient
health information generated by one or more encounters in any care delivery setting.
Included in this information are patient demographics, progress notes, problems,
medications, vital signs, past medical history, immunizations, laboratory data and
radiology reports.” – HIMSS, 2010
• Colloquial Definition – Computer records in a doc’s offices
that can talk to pharmacies, has decision support, talks to
hospitals, improves quality, decreases costs, and saves the world
Adoption Definitions
•Patient
Demographics
•Problem Lists
•Clinical Notes
•Rx Orders
•Lab Results
•Imaging
Results
6%
Full
•Any EHR
Adoption
21%
Basic
Any
44%
•All Basic
Requirements
•Medical
History/Follow
Up
•Test Orders
•Rx/Test Orders
sent
Electronically
•Drug/Drug
Interactions
EHR Adoption Rates
Accenture, Any (Small Practices)
50.00%
xxx, Any (Internal Medicine)
45.00%
Kemper, Any (Pediatricians)
40.00%
Modern Medicine, Any (PCP)
35.00%
NAMCS, Any
30.00%
Simon et al, All (Physician Practices)
25.00%
SK&A, Any
20.00%
DesRoches, Basic (All Physicians)
15.00%
NAMCS, Basic
Accenture, Full (Small Practices)
10.00%
DesRoches, Full
5.00%
NAMCS, Full
0.00%
2004
2005
2006
2007
2008
2009
2010
2011
Adoption Definitions
•Patient
Demographics
•Problem Lists
•Clinical Notes
•Rx Orders
•Lab Results
•Imaging
Results
6%
Full
•Any EHR
Adoption
21%
Basic
Any
44%
•All Basic
Requirements
•Medical
History/Follow
Up
•Test Orders
•Rx/Test Orders
sent
Electronically
•Drug/Drug
Interactions
HITECH… and Meaningful Use
• The Health Information Technology for Economic and Clinical
Health (HITECH) Act of 2009 was a part of ARRA
• Allocated funds to spur the adoption of electronic health records
- mostly administered through ONC and CMS
• Incentive Payments for Meaningful Use are administered through
CMS
– Medicare: Maximum Incentive = $44k/physician
– Medicaid: Maximum Incentive = $63k/physician
– Incentives will be paid 2011- 2016, then penalties will begin
• Meaningful Use Rules were released July 13, 2010
Basically…
EHR Adoption Rates
Accenture, Any (Small Practices)
50.00%
xxx, Any (Internal Medicine)
45.00%
Kemper, Any (Pediatricians)
40.00%
Modern Medicine, Any (PCP)
35.00%
NAMCS, Any
30.00%
Simon et al, All (Physician Practices)
25.00%
SK&A, Any
20.00%
DesRoches, Basic (All Physicians)
15.00%
NAMCS, Basic
10.00%
Accenture, Full (Small Practices)
DesRoches, Full
5.00%
NAMCS, Full
0.00%
2004
2005
2006
2007
2008
2009
2010
2011
Key Take-Aways
• The rates of ambulatory adoption have risen
significantly over the past five years
• Unfortunately that increase in adoption has
not translated into “meaningful” adoption
• The current rate of meaningful adoption is
6.3%, hopefully new rules and certifications
will help increase this percentage